Gastrointestinal Complications of Acute Respiratory Failure

In Brief Complications in the gastrointestinal tract of critically ill patients with acute respiratory failure are extremely common. This susceptibility to injury is likely due to a myriad of factors, including splanchnic hypoperfusion, hypoxemia, inflammatory cytokine release, and altered tissue pH, as well as the underlying illness that first caused respiratory failure. This review details the most common gastrointestinal problems associated with the first 48 hours of respiratory failure. Specifically, we discuss the pathogenesis and pathophysiology of pneumoperitoneum and gastric rupture, gastrointestinal hemorrhage and its causes, gastrointestinal dysmotility, hepatic injury, pancreatitis, and acute acalculous cholecystitis and their relationship to acute respiratory failure. This review details the most common gastrointestinal problems associated with acute respiratory failure. Emphasis is on complications that occur within the fist 48 hours of the onset of respiratory failure, followed by a discussion of possible pathophysiologic mechanisms involved.